Alumni Update Info Form

At Terra State, we value our alumni and want to ensure that we can keep in touch.
Please use the form below to update your contact information. We do not sell or share
this information with anyone outside of the College.

If you see this don't fill out this input box.

Personal Information - please update any personal information that has changed or complete the entire form if you are unsure what we have on file

First Name*Please enter your first name

Last Name*Please enter your last name

Middle InitialPlease enter your middle initial

Maiden NamePlease enter your maiden name (if you have one)

What year did you graduate from Terra State?Please enter the year you graduated

What degree did you earn?Please enter the degree you received

Address*Please enter your address

Address (additional)If you have additional address info such as a lot number, please enter here

City*Please enter your city

State*Please choose a state

Zipcode*Please enter your five-digit zipcode

Spouse First NamePlease enter your spouse's first name (if applicable)

PhoneBest number to reach you

Alternate PhoneIs there another phone number we can reach you at?

Spouse Last NamePlease enter your spouse's last name (if applicable)

Is your spouse a Terra State Alum?

Yes

No

Choose an answer if applicable

OccupationPlease enter your occupation

EmployerPlease enter your current or previous employer

Additional InformationPlease enter any other information you'd like to share with us (wedding, birth announcements,
social media handles, etc.)

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If you would prefer us not to share this info in our alumni newsletter, please select
DO NOT PUBLISH